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Gastroenterology Clinics of North... Jun 2020Pyogenic liver abscesses are classified by the bacteria that have caused the abscess because this guides treatment and can point to the underlying cause. The most common... (Review)
Review
Pyogenic liver abscesses are classified by the bacteria that have caused the abscess because this guides treatment and can point to the underlying cause. The most common cause is biliary disease. The diagnosis is made by imaging. Treatment is a combination of antibiotics and percutaneous drainage. Amebic liver abscess is caused by extraintestinal spread of Entamoeba histolytica. E histolytica is spread by fecal-oral transmission and typically colonizes the gastrointestinal tract. It is diagnosed based on imaging and the mainstay of treatment is metronidazole. Only about 15% of cases require percutaneous drainage. The prognosis is good, with almost universal recovery.
Topics: Anti-Bacterial Agents; Drainage; Entamoeba histolytica; Humans; Liver Abscess, Amebic; Liver Abscess, Pyogenic; Metronidazole; Tomography, X-Ray Computed; Ultrasonography
PubMed: 32389368
DOI: 10.1016/j.gtc.2020.01.013 -
British Medical Bulletin Dec 2019Liver abscesses are mainly caused by parasitic or bacterial infection and are an important cause of hospitalization in low-middle income countries (LMIC). The... (Review)
Review
INTRODUCTION
Liver abscesses are mainly caused by parasitic or bacterial infection and are an important cause of hospitalization in low-middle income countries (LMIC). The pathophysiology of abscesses is different depending on the etiology and requires different strategies for diagnosis and management. This paper discusses pathophysiology and epidemiology, the current diagnostic approach and its limitations and management of liver abscess in low resource settings.
SOURCES OF DATA
We searched PubMed for relevant reviews by typing the following keywords: 'amoebic liver abscess' and 'pyogenic liver abscess'.
AREAS OF AGREEMENT
Amoebic liver abscess can be treated medically while pyogenic liver abscess usually needs to be percutaneously drained and treated with effective antibiotics.
AREAS OF CONTROVERSY
In an LMIC setting, where misuse of antibiotics is a recognized issue, liver abscesses are a therapeutic conundrum, leaving little choices for treatment for physicians in low capacity settings.
GROWING POINTS
As antimicrobial resistance awareness and antibiotic stewardship programs are put into place, liver abscess management will likely improve in LMICs provided that systematic adapted guidelines are established and practiced.
AREAS TIMELY FOR DEVELOPING RESEARCH
The lack of a quick and reliable diagnostic strategy in the majority of LMIC makes selection of appropriate treatment challenging.
Topics: Anti-Bacterial Agents; Humans; Liver Abscess; Liver Abscess, Amebic; Liver Abscess, Pyogenic; Medically Underserved Area; Prognosis
PubMed: 31836890
DOI: 10.1093/bmb/ldz032 -
Revue Des Maladies Respiratoires Jun 2019Lung abscesses are necrotic cavitary lesions of the lung parenchyma. They are usually caused by anaerobic bacteria or mixed flora and typically occur after aspiration.... (Review)
Review
Lung abscesses are necrotic cavitary lesions of the lung parenchyma. They are usually caused by anaerobic bacteria or mixed flora and typically occur after aspiration. Primary lung abscesses occur in previously healthy patients with no underlying medical disorders and are usually solitary. Secondary lung abscesses occur in patients with underlying or predisposing conditions and may be multiple. The initial diagnosis is usually made by chest radiography showing a lung cavity with an air-fluid level. Typically, the cavity wall is thick and irregular, and a surrounding pulmonary infiltrate is often present. The differential diagnosis of pulmonary cavitation is wide, including different types of possible infections, neoplasia and malformations of the bronchial tree. Management is usually based on prolonged antibiotic treatment. Failure of conservative management, manifested by the persistence of sepsis and/or other abscess complications, may necessitate drainage with invasive techniques (percutaneous, endoscopic or surgical) or open surgical removal of the lung lesion in patients with good performance status and sufficient respiratory reserve.
Topics: Diagnosis, Differential; Humans; Lung Abscess
PubMed: 31202603
DOI: 10.1016/j.rmr.2018.07.010 -
Primary Care Mar 2022An abscess is a localized collection of purulent material surrounded by inflammation and granulation in response to an infectious source. Most simple abscesses can be... (Review)
Review
An abscess is a localized collection of purulent material surrounded by inflammation and granulation in response to an infectious source. Most simple abscesses can be diagnosed upon clinical examination and safely be managed in the ambulatory office with incision and drainage. Wound culture and antibiotics do not improve healing, but packing wounds larger than 5 cm may reduce recurrence and complications.
Topics: Abscess; Anti-Bacterial Agents; Anus Diseases; Drainage; Humans
PubMed: 35125157
DOI: 10.1016/j.pop.2021.10.002 -
The Surgical Clinics of North America Dec 2022Peripheral nonlactational abscesses behave like other soft tissue abscesses and resolve with drainage and antibiotics. Subareolar abscesses tend to recur or develop... (Review)
Review
Peripheral nonlactational abscesses behave like other soft tissue abscesses and resolve with drainage and antibiotics. Subareolar abscesses tend to recur or develop fistulae between obstructed ducts and the border of the areola and are usually seen in women in their thirties who have a history of smoking or a congenitally cleft nipple. The underlying cause of subareolar abscesses and fistulae is the obstruction of terminal ducts due to keratin plugging caused by squamous metaplasia of the ducts. Successful resolution of the problem requires excision of the terminal ducts in and just below the nipple along with the correction of nipple deformity, if present.
Topics: Female; Humans; Abscess; Mastitis; Breast Diseases; Nipples; Fistula
PubMed: 36335928
DOI: 10.1016/j.suc.2022.06.007 -
American Family Physician Jun 2019The Bartholin glands, located in the base of the labia minora, have a role in vaginal lubrication. Because of the presence of other glands, removal of a Bartholin gland...
The Bartholin glands, located in the base of the labia minora, have a role in vaginal lubrication. Because of the presence of other glands, removal of a Bartholin gland does not affect lubrication. Ductal blockage of these typically pea-sized structures can result in enlargement of the gland and subsequent development of Bartholin duct cysts or gland abscesses. Two percent of women will develop a cyst or an abscess in their lifetime, and physicians should be familiar with the range of treatment options. Bartholin duct cysts and gland abscesses can be treated in the office. The healing and recurrence rates are similar among fistulization, marsupialization, and silver nitrate and alcohol sclerotherapy. Needle aspiration and incision and drainage, the two simplest procedures, are not recommended because of the relatively increased recurrence rate.
Topics: Abscess; Adult; Aged; Aged, 80 and over; Ambulatory Surgical Procedures; Bartholin's Glands; Cysts; Female; Humans; Middle Aged; Practice Guidelines as Topic
PubMed: 31194482
DOI: No ID Found -
The Journal of Emergency Medicine Jan 2022Cellulitis and abscess are a common reason for presentation to the emergency department, although there are several nuances to the care of these patients. (Review)
Review
BACKGROUND
Cellulitis and abscess are a common reason for presentation to the emergency department, although there are several nuances to the care of these patients.
OBJECTIVE
The purpose of this narrative review article was to provide a summary of the background, pathophysiology, diagnosis, and management of cellulitis and abscesses with a focus on emergency clinicians.
DISCUSSION
The most common bacteria causing cellulitis are Staphylococcus aureus, Streptococcus pyogenes, and other β-hemolytic streptococci, and methicillin-resistant S. aureus is most common in abscesses. The history and physical examination are helpful in differentiating cellulitis and abscess in many cases, and point-of-care ultrasound can be a useful tool in unclear cases. Treatment for cellulitis typically involves a penicillin or cephalosporin, and treatment of abscesses is incision and drainage. Loop drainage is preferred over the traditional incision and drainage technique, and adjunctive antibiotics can be considered. Most patients can be managed as outpatient.
CONCLUSIONS
It is essential for emergency physicians to be aware of the current evidence regarding the diagnosis and management of patients with cellulitis and abscess.
Topics: Abscess; Anti-Bacterial Agents; Cellulitis; Drainage; Emergency Service, Hospital; Humans; Methicillin-Resistant Staphylococcus aureus; Ultrasonography
PubMed: 34657784
DOI: 10.1016/j.jemermed.2021.09.015 -
Child's Nervous System : ChNS :... Jul 2019The purpose of the paper is to examine the current state of the art about epidemiology, diagnosis, and treatment of this infection. (Review)
Review
OBJECTIVE
The purpose of the paper is to examine the current state of the art about epidemiology, diagnosis, and treatment of this infection.
METHODS
A review of the literature was performed through a PubMed search of original articles, case reports, and reviews using the key words "brain abscess," "cerebral abscess," "brain infection," "intracranial suppuration," "otogenic brain abscess," "otitis complications," and "sinusitis complications."
RESULTS
Pediatric brain abscess is a rare but serious infection, often involving patients with specific risk factors and burdened by a high risk of morbidity and mortality. Brain abscess incidence and mortality decreased over the years, thanks to improved antibiotic therapy, new neurosurgical techniques, and the wide spread of vaccinations. There are no guidelines for the adequate diagnostic-therapeutic pathway in the management of brain abscesses; therefore, conflicting data emerge from the literature. In the future, multicentric prospective studies should be performed in order to obtain stronger evidences about brain abscesses management. Over the next few years, changes in epidemiology could be observed because of risk factors changes.
Topics: Anti-Bacterial Agents; Brain Abscess; Child; Humans; Neuroimaging; Neurosurgical Procedures
PubMed: 31062139
DOI: 10.1007/s00381-019-04182-4 -
European Journal of Pediatric Surgery :... Oct 2020Perianal abscess (PA) and fistula-in-ano (FIA) are common entities in infancy. Although several hypotheses have been suggested, the pathogenesis of PA/FIA remains... (Review)
Review
Perianal abscess (PA) and fistula-in-ano (FIA) are common entities in infancy. Although several hypotheses have been suggested, the pathogenesis of PA/FIA remains elusive. The natural course of these diseases in infancy is self-limiting in the majority of cases whereas older children show similarities to PA/FIA in adults. It is important to rule out rare differential diagnoses of PA/FIA such as inflammatory bowel disease (IBD), surgical complications after colorectal surgery, and immunodeficiencies. Treatment remains empiric, comprises conservative, as well as surgical approaches, and is dependent on the age of the patient. This review summarizes anatomical aspects, current evidence on disease pathogenesis, clinical presentation, and management of pediatric patients with PA and FIA.
Topics: Abscess; Adolescent; Child; Child, Preschool; Conservative Treatment; Diagnosis, Differential; Female; Fissure in Ano; Humans; Infant; Male; Rectal Fistula; Surgical Procedures, Operative
PubMed: 32987435
DOI: 10.1055/s-0040-1716726 -
Zentralblatt Fur Chirurgie Dec 2020Lung abscess is a localized infectious pus-filled cavity of the lung tissue by viral, bacterial, mycotic or parasitic pathogens. Currently, there are different...
Lung abscess is a localized infectious pus-filled cavity of the lung tissue by viral, bacterial, mycotic or parasitic pathogens. Currently, there are different classifications, which are based primarily on the genesis and duration of symptoms. Important steps for diagnosis are in addition to clinical examination, laboratory and chest X-ray especially bronchoscopy with microbiological examinations and computed tomography. Treatment of lung abscesses continues to be a domain of conservative antibiotic therapy. The vast majority of cases can be cured with this. Interventional procedures such as transthoracic or endobronchial abscess drainage with subsequent irrigation can effectively support the healing process. Thoracic surgery is particularly important in cases of failure of conservative and interventional therapy as well as secondary abscesses on the basis of a lung carcinoma. Mostly anatomical resections are required. Alternatively, VAC therapy (vacuum-assisted closure therapy) may be considered in seriously ill, old, immunosuppressed, and multimorbid patients with complicated abscesses (e.g. perforation in the pleural cavity and sero-pneumothorax).
Topics: Bronchoscopy; Drainage; Humans; Lung Abscess; Negative-Pressure Wound Therapy; Pneumothorax
PubMed: 33260228
DOI: 10.1055/a-0949-7414